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PubMed2002

Living with a schizophrenic patient: a comparative study of burden as it affects parents and spouses.

Based on the analysis of 42 in-depth interviews, this article highlights different aspects of the subjective burden experienced by parents and spouses of patients suffering from schizophrenia. The onset of a schizophrenic disorder and acute episodes during the later course of the disease lead to considerable emotional distress for the patients' caregivers. In everyday life with the patient, parents and spouses experience a comparatively less dramatic chronic burden, which nevertheless can severely affect their living situation and well-being. Caregivers often feel disappointed and dissatisfied with the information and cooperation offered by psychiatric institutions. Parents and spouses perceive the caregiver burden differently, although there are some apparent similarities. The study reveals that the symptoms of a schizophrenic disorder as well as different family roles contribute to the subjective burden of parents and spouses. Supportive assistance for schizophrenic patients' caregivers should address their particular needs more adequately.

Adaptation, Psychological↗
PubMed2004

Comparing different types of child abuse and spouse abuse offenders.

This study examined differences in offenders' background characteristics, personal and interpersonal problems, and family climate between three types of child abuse offenders (neglecters, physical abusers, and psychological abusers) and two forms of spouse abuse offenders (physical abusers and psychological abusers) in two large samples (child abuse n = 2,910; spouse abuse; n = 7,035) of cases officially identified over a 8-year period (1988-1995) by the U.S. Air Force Family Advocacy Program. Comparisons addressed demographic factors, personal and interpersonal problems, and aspects of family climate. Among child abusers, results supported the conclusion that types of child abuse varied with offender demographics and family climate factors. For spouse abusers, however, types of abuse were not as distinctly different in terms of the comparison variables. In general, therefore, for child abuse--but not for spouse abuse--findings challenge the view of abuse as a unitary phenomenon.

Adult↗
PubMed2004

Benefits to police officers of having a spouse or partner in the profession of police officer.

This exploratory study of police officers examined potential effects of having a spouse or partner who is also in police work on levels of work-family conflict and spouse or partner concerns. Data were collected from 776 police officers in Norway using anonymously completed questionnaires. Police officers having spouses or partners also in police work reported significantly lower spouse or partner concerns but the same levels of work-family conflict. Possible explanations for these findings are offered.

Adult↗
PubMed2001

Subjective responses to caregiving for a spouse with dementia.

Family members, typically spouses, serve as the primary caregivers for individuals with dementia. While it is recognized that caregivers experience both positive and negative subjective responses to caregiving, relatively little research has been done on the relationship between these types of responses. The objectives of the study were to examine the relationships between and among spouse caregivers' positive and negative subjective responses to caregiving, and increase understanding of the experience of being a spouse caregiver for a person with dementia. Fifty spouse caregivers completed quantitative measures of positive subjective responses (Positive Aspects of Caregiving and Caregiver Competence) and negative subjective responses (Relational Deprivation, Role Captivity, and Loss of Self). Additionally, participants were interviewed concerning their caregiving experiences. Positive Aspects of Caregiving and Caregiving Competence were significantly related to each other (p < .01), as were the three measures of negative subjective responses (p < .01). No significant correlations were found between any measures of a positive and a negative subjective response, suggesting the two types of responses are independent. Duration of caregiving was significantly related to Positive Aspects of Caregiving (p < .05), Caregiver Competence (p < .05), and Relational Deprivation (p < .01). Qualitative interview data revealed that participants simultaneously experienced caregiving as self-affirming, while also enduring losses and difficulties resulting from their caregiving role. Integrating the positive and negative aspects of the whole of caregiving is important to understand the caregiving experience and to design interventions to support caregivers.

Aged↗
PubMed2000

[Colorectal cancer in spouses of colorectal cancer patients].

Married couples share home environments and life style for years. In the case of colorectal cancer, an association with insulin resistance was reported. We determined the presence of the insulin-resistance syndrome (IRS, 1 or more of the following: body mass index of > 25 kg/m2, diabetes, or hyperlipidemia) in 84 colorectal cancer patients, of whom 61 patients (73%) had IRS. The incidence of the distal colorectal cancer, which has been declining in the United States, was significantly higher in the IRS group than in the non-IRS group (75.4 vs 52.2%, p = 0.0400). Some mechanisms may promote the progression of mucosal lesions to invasive cancers in the distal colorectum. There were no significant differences with respect to the age (64.6 +/- 9.4 vs 64.3 +/- 11.3 yr, p = 0.8298), height (159 +/- 9 vs 157 +/- 8 cm, p = 0.1375), and body mass index (22.2 +/- 3.6 vs 22.4 +/- 2.7 kg/m2, p = 0.6364) between the patients and their spouses. In 84 couples in whom colorectal cancer develops at least in one may then not illustrate the nursery rhyme: "Jack Sprat could eat no fat, His wife could eat no lean...". The spouses had been married for an average of 38 years, and in 30 spouses who had been followed in a colorectal cancer screening, 5 developed colorectal cancer. To diminish the incidence of colorectal cancer in Japan, we might advise screening colonoscopy to the spouses of colorectal cancer patients, or déjà vu all over again?

Aged↗
PubMedDate not supplied

Going it alone: the experiences of spouses of critically ill patients.

Spouses of critically ill patients are faced with major changes in responsibilities while their spouse is in the intensive care unit. Using grounded theory methods, this qualitative study investigated the changes in responsibilities and the impact these additional responsibilities (such as financial decision making and child care) had on patients' spouses. Patients' spouses need help to meet their needs and alleviate some stress so they can "be there" for their critically ill partner.

Critical Illness↗
PubMed2003

The Codman Award Paper: quality of life in stroke survivors and their spouses: predictors and clinical implications for rehabilitation teams.

Valuing and promoting quality of life after stroke is an essential component of practice for neuroscience nurses and other clinicians working in rehabilitation settings. Although some research studies have addressed factors that contribute to quality of life post-stroke, the majority of studies have focused on stroke survivors, not their spouses. Additionally, little attention has been given to family strengths associated with quality of life. In this paper, the investigator presents the findings of a recent descriptive, correlational study that was based on the conceptual framework of the Developmental Model of Health and Nursing (DMHN) (Allen & Warner, 2002; Ford-Gilboe, 2002a). This was the first study to examine the relationships among hope, family health promoting activity, and quality of life. The study was conducted with a convenience sample of 40 stroke survivors with moderate to severe functional impairments and their spouses. Participants had completed a rehabilitation program. Spouses' employment status, number of supports, and functional independence at discharge were common predictors of quality of life for both partners. However, hope was found to contribute to quality of life of stroke survivors, but not their spouses. The different patterns of findings are discussed and the key implications for clinical and research practice are addressed.

Activities of Daily Living↗
PubMed2003

Study of social support in the spouses of depressives.

This study was conducted to asses the level of social support amongst the patients of disthymia and unipolar depression. A total of 80 patients with their spouses were included. Results showed no significant differences of social support in this study group. Spouses of patients with unipolar depression with psychotic features perceived lower social support compared with the spouses of unipolar depression without psychotic features. The severity of unipolar depression of the patients correlated negatively with the perceived social support of the spouses.

Adult↗
PubMed2004

[The effect of spouse participation in cardiac rehabilitation program on patients' compliance and exercise level].

BACKGROUND: Exercise-based cardiac rehabilitation programs have proven to be associated with decreased morbidity and mortality after cardiac events. Unfortunately, attendance is often poor, and long term compliance is low. This study examined the effect of the active participation of spouses in the exercise program on the compliance and physical fitness level of their partners. METHODS: During the years 1998-2001, 24 couples joined our cardiac rehabilitation program. The couples were divided into 2 groups on the basis of their medical status. In Group 1--Rehabilitation program (n = 14); one of the couple had suffered a myocardial infraction or underwent a coronary bypass surgery at least 3 weeks before starting the program. In Group 2--secondary prevention (n = 10); one of the couple had a medical history of cardiac disease. The third Group included the spouse. Each group was compared with a matched control group based on their medical condition. The parameters that were measured were: the number of sessions attended, basic and final physical training level. RESULTS: In the rehabilitation groups, the participants attended a larger number of sessions (87.3 + 17) compared to control (47.7 + 6) (p < 0.05). There was no difference in the basic training level between the groups (3.5 + 0.2 METS; compared with 3.4 + 0.2 METS) (P = 0.5) and both groups had similarly improved their training level by 0.79 + 0.1 METS compared with 0.6 + 0.1 METS in the control group (p = 0.2). In the secondary preventive groups, the control group attended a larger number of sessions (51 + 13 compared with 31.2 + 6 sessions) (p < 0.02). There was no difference in the basic training level between groups 3.7 + 0.3 METS compared with 4.2 + 0.2 in the control group (p = 0.2). However, at the end of the training period, the control group showed greater improvement in their training level by 0.7 + 0.2 METS compared to 0.3 + 0.1 METS (p < 0.05). The spouses themselves had attended a greater number of sessions (45 + 10 compared with 37 + 6 in the control group) (p = 0.2). There was no difference between those groups in the training level at baseline and at the end of training period. CONCLUSION: Active support during the rehabilitation program may improve the rates of participation but in the secondary prevention program active spouse support may encourage early dropout.

Aged↗
PubMed2005

The lived experience of spouses of patients with a left ventricular assist device before heart transplantation.

BACKGROUND: No publications describe the life experience of spouses who are designated caregivers of patients with a left ventricular assist device before transplantation. OBJECTIVE: To explore what life is like for spouses serving as caregivers of patients with a left ventricular assist device before transplantation and to assess the meaning of such experience to them. METHODS: This phenomenological study included 3 women 38 to 52 years old who were designated caregivers of patients with a left ventricular assist device while the patients were waiting at home for a heart transplant. RESULTS: Three major themes emerged-emotional distress, determination, and optimism: a new lease on life. The identified themes were elucidated by 8 subthemes: guilt and realization of severity of illness, fear and anxiety, recognition that being a caregiver is an overwhelming experience and a burden, coping, living with hope, realization of loving relationship, adaptation to a new life, and joyful feeling. CONCLUSION: The spouses who served as caregivers had strong emotions as they entered each stage of this life experience. The stages were characterized by the identified themes and subthemes, which otherwise might not have been revealed or might have remained private to the study participants. Critical care nurses should recognize and anticipate challenges for these stages of life experienced by the spouses as caregivers. Heightened awareness of this phenomenon will guide nurses in individualizing plans of care, educating patients and patients' families, and evaluating outcomes of care.

Adult↗
PubMed1991

Community-based spouse abuse protection and family preservation team.

Fragmentation and lack of communication plague agencies that serve families in which spouse abuse occurs. Spouse-abuse families may have service needs that span the fields of medical, legal, and social services; law enforcement; and employment. This article provides a brief overview of the multiple service needs of spouse-abuse families and describes a framework for developing, organizing, and implementing a community-based spouse abuse protection and family preservation team. The proposed model recognizes the needs of victims, perpetrators, and their family members.

Community Health Services↗
PubMed1989

Research note: the response of the clergy to spouse abuse in a suburban county.

An attempt was made to study the response of religious organizations to spouse abuse in a suburban county in the state of Maryland. Clergy members representing a variety of denominations from 143 churches and synagogues were surveyed. The presence of an ongoing problem-oriented discussion group as part of clergy functions was positively related to the identification of spouse abuse. More than half of the responding clerics acknowledged the need to improve efforts in addressing spouse abuse. Victim reticence to seek help, and lack of information about state law, legal options, and programs for spouse abusers were identified as major factors hampering response. Recommendations are made to improve linkages between the clergy and other involved community groups.

Attitude↗
PubMed1995

Evidence of transmission of hepatitis D virus to spouses from sequence analysis of the viral genome.

To study sexual transmission of hepatitis D virus (HDV), 52 spouses of 56 index patients were observed and HDV genomes from antibody to HDV (anti-HDV)-positive couples were sequenced. Of the spouses, 11 (21%) were serum HBsAg positive, 3 (27%) of whom were also anti-HDV positive. The HDV sequences between spouses were found to be nearly identical (98% to 98.8%) in the region analyzed (nt 911 to nt 1260). Only one couple showed an identity > 90% with the genotype I HDV strains. The HDV sequences of the remaining two couples showed > 95% identity with each other and > 91% homology with genotype II, but they shared only a 73.1% to 73.7% homology with those of the first couple. The regions corresponding to the autocatalytic cleavage sites, the junction between the middle and the carboxyl terminal one-third domains, and the middle domain of the open reading frame for delta antigen on the antigenomic HDV RNA were more conserved with < 19% divergence among the three couples. Interestingly, there was a 56% divergence in the region corresponding to the carboxyl end of the open reading frame for the large delta antigen on the antigenomic HDV RNA. In summary, this study provides a direct nucleotide evidence of a common source of HDV infection in each couple. Despite divergence in the viral nucleotide sequence, both genotypes I and II were found in Taiwan and were transmitted from patients with a history of prostitute contact to spouses through sexual contact.

Base Sequence↗
PubMedDate not supplied

[Aged couples and management of dependence. Study of 75 helping spouses].

The article displays the findings of a survey conducted among 34 husbands and 41 wives who are helping their disabled spouses. The questionnaire deals with the degree of dependency of the helped spouse, his/her health status, the health status of the helper, how the latter copes with the helping tasks, how these tasks are felt and carried out, how is the relationship between the spouses in the past and at present, what are the prospects envisaged by the helper regarding in particular the transfer of the disabled spouse to a nursing home. A scale is used for measuring the various answers.

Activities of Daily Living↗
PubMed1994

"Shadows of the heart": a dramatic video for the treatment resistance of spouse abusers.

Successful intervention with spouse abusers, most of whom are ordered into treatment by the courts, must overcome formidable anger and resistance, often expressed by high attrition and scant participation in the group treatment process. The dramatic video "Shadows of the Heart" dissipates client resistance by providing internal motivation to control violent behavior. The video dramatizes spouse abuse from the viewpoint of a young boy, who as a man has become a spouse abuser. As clients experience compassion for the child witness to family violence, they learn to convert their habitual anger response into nonviolent actions. Developed to combat treatment resistance, the video presentation was tested in a randomized experiment with 106 male spouse abusers drawn from seven public and private agencies. Results indicate that the video presentation significantly increased attendance and participation in the group treatment process.

Adult↗
PubMed1996

Stress among general practitioners and their spouses: a qualitative study.

BACKGROUND: Although research has been carried out on stress in general practitioners, little is known about the stresses experienced by their spouses. AIM: This study was undertaken to identify specific pressures at work and at home experienced by general practitioners and their spouses and to highlight their coping strategies. METHOD: In-depth interviews were conducted with 25 general practitioners and their spouses in the north-west of England. RESULTS: The doctors' increased workload and decreased interest in their family are important stressors for the entire family unit. Other stressors include time pressure, out-of-hours on-call, lack of support and amount of paperwork. General practitioners work late in the surgery, bring work home and spend time away from home at meetings. Family life is constantly interrupted by telephone calls. Role conflict was one of the major sources of stress for women general practitioners. Doctors' wives expressed concern regarding their husbands' excessive commitment to work and problems with communication. CONCLUSION: Recent changes to contractual working conditions have caused general practitioners to focus their energies on their practice instead of paying attention to the needs of their family. Male general practitioners leave the bulk of responsibility for running the family and household to their wives, but women general practitioners appear to maintain domestic responsibility while spending as much time in medical practice as their male colleagues. This is only an exploratory study based on a small sample, and so the findings cannot be generalized; however, it provides in-depth information on stress among general practitioners and their spouses.

Adaptation, Psychological↗
PubMed1996

Spouse concordance of obesity, blood pressures and serum risk factors for atherosclerosis.

Familial aggregation of atherosclerotic risk factors is well known, however inter-spouse relation of the risk factors has remained controversial. As spouses are not blood-related, any risk factor relation probably does not reflect genetic factors, but the environmental factors to which the couple is exposed. Moreover, the effect of assortative marriage should be considered. The present study enrolled 97 married couples who attended a general health screening in 1993 in a mountain village of Japan. The screening was conducted between April and November at a single outpatient clinic in the village. Data on weight, height, blood pressure (BP), serum risk factors for atherosclerosis and marriage year were obtained as part of the screening programme. They were divided into three groups according to marital duration. The simple correlation coefficients for systolic/diastolic BP between the spouses were 0.22/0.19. The coefficients declined to 0.05/0.08 after controlling. The correlation coefficients for serum lipoproteins were low and between -0.06 and 0.11 after controlling. The correlation coefficients for blood sugar were -0.05 and -0.13 after controlling. In subgroup analyses stratified by marital duration, the correlation coefficients for BP, body mass index (BMI) and blood sugar were increased in both the short and long marital duration groups. The correlation coefficients for high-density lipoprotein (HDL) cholesterol and triglycerides increased with longer marital duration. Although a larger population study will be needed to confirm these findings, these results suggest the presence of interspouse correlation and reflect the influence of assortative marriage and environmental factors on spouse concordance.

Aged↗
PubMed1983

Personality variables in coping with the stress of a spouse's chronic illness.

Identified systematically those spouses of male VA hemodialysis patients who are at risk for experiencing difficulties in adapting to their husband's chronic kidney failure and hemodialysis treatment. To this end, an exploration was made of personality variables that might enhance a spouse's ability to cope with the unique stress of living with chronic illness. Fifty-six wives of VA dialysis patients were administered the Rotter Internal-External Locus of Control Scale (I-E), the Multidimensional Locus of Control Scale (MLC), the Multidimensional Health Locus of Control Scale (MHLC), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). Significant relationships were found between I-E scores and all measures of emotional adjustment (state anxiety, trait anxiety, and depression) for the entire sample of spouses in general, and also for a subgroup of home dialysis spouses who were analyzed separately. Results were discussed in terms of the role that locus of control orientation plays in mediating the stress of living with chronic illness, as well as the failure to find relationships between adjustment and the MLC or the area-specific MHLC.

Adaptation, Psychological↗